Individual
DR. JOSEPH LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9945
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036110613
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110613
—
IL
01
—
110123
BLUE SHIELD
IL
Enumeration date
04/13/2007
Last updated
05/19/2016
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